Obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) features a pattern of unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress.

You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior â€” the vicious cycle of OCD.

OCD often centers around certain themes â€” for example, a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they're sore and chapped.

If you have OCD, you may be ashamed and embarrassed about the condition, but treatment can be effective.

Symptoms

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social or work functioning.

Obsession symptoms

OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual. These obsessions typically intrude when you're trying to think of or do other things.

Obsessions often have themes to them, such as:

Fear of contamination or dirt

Needing things orderly and symmetrical

Aggressive or horrific thoughts about harming yourself or others

Unwanted thoughts, including aggression, or sexual or religious subjects

Examples of obsession signs and symptoms include:

Fear of being contaminated by touching objects others have touched

Doubts that you've locked the door or turned off the stove

Intense stress when objects aren't orderly or facing a certain way

Images of hurting yourself or someone else that are unwanted and make you uncomfortable

Thoughts about shouting obscenities or acting inappropriately that are unwanted and make you uncomfortable

Avoidance of situations that can trigger obsessions, such as shaking hands

Distress about unpleasant sexual images repeating in your mind

Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to prevent or reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you're having obsessive thoughts. These compulsions are excessive and often are not realistically related to the problem they're intended to fix.

As with obsessions, compulsions typically have themes, such as:

Washing and cleaning

Checking

Counting

Orderliness

Following a strict routine

Demanding reassurances

Examples of compulsion signs and symptoms include:

Hand-washing until your skin becomes raw

Checking doors repeatedly to make sure they're locked

Checking the stove repeatedly to make sure it's off

Counting in certain patterns

Silently repeating a prayer, word or phrase

Arranging your canned goods to face the same way

Severity varies

OCD usually begins in the teen or young adult years. Symptoms usually begin gradually and tend to vary in severity throughout life. Symptoms generally worsen when you experience greater stress. OCD, usually considered a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling.

When to see a doctor

There's a difference between being a perfectionist â€” someone who requires flawless results or performance, for example â€” and having OCD. OCD thoughts aren't simply excessive worries about real problems in your life or liking to have things clean or arranged in a specific way.

If your obsessions and compulsions are affecting your quality of life, see your doctor or mental health professional.

Causes

Biology. OCD may be a result of changes in your body's own natural chemistry or brain functions.

Genetics. OCD may have a genetic component, but specific genes have yet to be identified.

Environment. Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed.

Risk factors

Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:

Family history. Having parents or other family members with the disorder can increase your risk of developing OCD.

Stressful life events. If you've experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.

Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Complications

Problems resulting from OCD may include, among others:

Health issues, such as contact dermatitis from frequent hand-washing

Inability to attend work, school or social activities

Troubled relationships

Overall poor quality of life

Suicidal thoughts and behavior

Prevention

There's no sure way to prevent obsessive-compulsive disorder. However, getting treatment as soon as possible may help prevent OCD from worsening and disrupting activities and your daily routine.